Yemen works to contain diphtheria outbreak

Yemen's Ministry of Public Health, alongside the World Health Organisation (WHO) and UNICEF, has been working to contain an outbreak of diphtheria in Ibb province, which has so far caused 10 fatalities among reported cases.

There are 110 suspected cases of diphtheria, said ministry spokesman and director-general of Disease Control and Surveillance Dr. Abdul Hakim al-Kahlani.

"The actual number of cases that meet the WHO case definition of the disease is 45," he told Al-Mashareq, adding that 10 of those with confirmed diphtheria cases have died, due to the serious nature of the disease.

Diphtheria can prove lethal, especially if medical care is lacking or if the patient suffers complications, he said.

A soon as the first cases were reported in late October, the ministry dispatched an investigative team to verify the cases and identify the cause of the spread, al-Kahlani said.

By November 3rd, it had launched a vaccination campaign with the support of WHO and UNICEF, which provided the vaccines and other supplies.

Lack of routine immunisation

The diphtheria outbreak in Ibb province has so far been confined to Yareem and al-Saddah districts, al-Kahlani said.

Diphtheria has not been eradicated in Yemen, he added, "because under the best circumstances, the coverage rate of the immunisation campaigns in Yemen in general does not exceed 86% of the targeted children".

"Every year, 14% of children go unvaccinated, and when their cumulative total grows over several years, we get an epidemic breakout," he said.

Though "we see suspected cases from time to time", he said, the current outbreak in Ibb is unprecedented.

Diphtheria is "a bacterial disease that is transmitted from the patient to a healthy person through respiratory droplets", al-Kahlani explained.

The current outbreak has occurred as "some villagers neglect to vaccinate their children, and there is dereliction of duty on the part of the Health Bureau", he said, noting that the medical unit that serves the area where the reported cases have occurred has been closed for some time.

"The vaccination coverage is weak, and there are cases among adults who were not vaccinated as children by their parents," he added.

Al-Kahlani warned of the spread of disease in areas with low vaccination rates.

"All the areas that have low immunisation coverage rates are vulnerable to epidemics that can be prevented with immunisation, such as diphtheria, measles, whooping cough, neonatal tetanus and others," he said.

Vaccines and health education

The rapid response team provides health and treatment services to the infected to prevent its transmission to others, said Dr. Abdulmalik al-Sanaani, director general of Ibb province health bureau.

"The immunisation campaign against the disease went on for four days, and targeted homes with cases of infection in Bait Halboub and Wasman," he said, as these are the areas where cases of diphtheria emerged.

The medical centres in those areas were reopened and supplied with vaccines and other medical supplies so they could resume their work, particularly routine prevention and immunisation-related activities, he said.

The immunisation campaign was accompanied by public health education and awareness-raising activities, said National Centre for Health Education and Information director Abdul-Salam Salam.

"The health education campaign targeted all parents and families in the two directorates and included the distribution of educational leaflets on the importance of routine immunisation and vaccination," he told Al-Mashareq.

The campaign was carried out in the areas affected by the current outbreak to change people’s misconceptions about immunisation, he added, noting that these were the cause of the emergence of cases of diphtheria infection.

Containing the outbreak

"The cause of the spread of diphtheria in the districts of al-Saddah and Yareem in Ibb is the lack of regular immunisation," said Dr. Ghada al-Haboub, director of the ministry's immunisation programme.

"One of the cases is a 16-year-old who has 12 siblings, and he is the only one to be infected with diphtheria, because all his siblings had received regular immunisations," she told Al-Mashareq.

The Ministry of Health will carry out a comprehensive dual-immunisation campaign in all districts of Ibb province for everyone over the age of 5, she said, because of the emergence of similar suspected cases in other directorates.

Suspected cases have been recorded in al-Dhahar and Badan, she said, adding that the ministry is waiting for vaccines from UNICEF to arrive so that any potential outbreak can be contained.